경피적 자궁동맥 색전술로 치료한 산후 출혈 1례

정명철,김호성,김경철,노지현,고재환,김용봉,권동일 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Postpartum hemorrhage remains one of the leading causes of maternal deaths. The major causes of postpartum hemorrhage include uterine atony, retained placental fragment, placenta accreta, and lower genital tract lacerations. Conservative treatment is based on administration of uterotonic drugs, vaginal packing, and surgical repair of genital tract lacerations. When bleeding fails to respond to conservative treatment, surgical ligation of uterine vessels or hemostatic hysterectomy is performed. We present a case of postpartum bleeding treated by selective uterine arterial embolization with a brief review of previous literatures of postpartum hemorrhage & uterine arterial embolization.

임신 중 고혈압성 질환에 대한 임상적 고찰

김경철,정명철,김호성,조민형,고재환,김용봉 白中央醫療院 2005 仁濟醫學 Vol.26 No.1

Objective: The aim of this study was to investigate the clinical charact eristics of pregnancy induced hypertension(PIH). Methods: We retrospectively evaluated the clinical characteristics through the collected data of 176 PIH cases treated at Seoul Paik hospital from March 1995 to December 2002. Results: The proportions of severe PIH, mild PIH, and chronic hypertension were 70%, 24%, and 6% of the cases, respectively. According to maternal age, the highest rate of 45% was noted in the group of 26-30 years of age. The rate of cesarean(80%) was higher than the rate of vaginal delivery(20%). The blood pressure was controlled by hydralazine for 70% of the patients. The rate of single gestation was 90%. The birthweight of 20% of the newborn were 2500gm or more. The anemia, twin pregnancy, postpartum hemorrhage, pulmonary edema, and infection were found in 30%, 10%, 3%, 2%, and 1% of the PIH patients, respectively. In respect of the perinatal complications, the rates of low birth weight, stillbirth, and neonatal death were 80%, 3%, and 1%, respectively. Conclusion: We were able to decrease the mortality and morbidity of PIH patients and neonates with strict antenatal care and proper treatment.

A Preliminary Report of Conization of the Cervix and Hysterectomy in the Management of Cervical Intraepithelial Neoplasia(CIN)

( Jae Whoan Koh ),( Duk Soo Bae ),( Je Ho Lee ) 대한산부인과학회 1996 대한산부인과학회 학술대회 Vol.77 No.-

Whole - Body Positron Emission Tomography with (Fluorine-18)-2-Deoxyglucose Can Detect Distant Metastasis of the Recurrent Corpus Cancer : Case Report

(Jae Whoan Koh),(Duk Soo Bae),(Je Ho Lee) 대한산부인과학회 1996 춘계학술대회 Vol.- No.-

Whole-Body Positron Emission Tomography with (Fluorine-18) -2-Deoxyglucose Can Detect Distant Metastasis of the Recurrent Corpus Cancer: Case Report

( Jae Whoan Koh ),( Duk Soo Bae ),( Je Ho Lee ) 대한산부인과학회 1996 대한산부인과학회 학술대회 Vol.77 No.-

A Preliminary Report of Conization of the Cervix and Hysterectomy in the Management of Cervical Intraepithelial Neoplasia CIN

(Jae Whoan Koh),(Duk Soo Bae),(Je Ho Lee) 대한산부인과학회 1996 춘계학술대회 Vol.- No.-

난황낭종으로 변형된 난소의 미분화세포종 : 면역조직화학적 연구

고재환(Jae Whoan Koh),강윤경(Yoon Kyung Kang),김용봉(Yong Bong Kim),이응수(Eung Soo Lee),박성관(Sung Kwan Park) 대한산부인과학회 1999 Obstetrics & Gynecology Science Vol.42 No.1

N/A Objective: The purpose of this article is to report mixed germ cell tumor, which revealed changes compatible with early transformation of dysgerminoma to endodermal sinus tumor(EST) through histogenetic considerations and immunohistochemical stains. Methods: Ovarian germ cell tumors were reviewed from files of Dept. Ob/Gyn. Seoul Paik Hospital fiom 1992.1 to 1996.12. Total of 5 cases include 4 pure dysgerminoma and 1 mixed germ cell tumars. All tissues were fixed in 10% neutral buffered formalin and embedded in paraffin and reviewed by two pathologists with immunohistochemical staining for cytokeratin, vimentin, AFP, PCNA, p53 & bc1-2. Results: Grossly, the areas of transformation were located at the middle of the mixed tumor. The outer layer of the tumor mass was filled with typical pure dysgerminoma. They were characterised as the presence of microcysts and small glandular structures in hematoxylin-eosin(H-E) stains with positive stain for vimentin, except the tissue of the EST. The cells in the intermediate layer were characterised as the mixed form of dysgerminomatous and EST structures in H-E stains. AFP in the dysgerminomatous cells in intermediate layer and EST were stained, but not in outer layer. Conclusion: Dysgerminoma may possess the ability to transform to EST. There might be intermediate stage between dysgerminoma and EST, and Immunohistochemical staining for AFP, cytokeratin, vimentin, PCNA also can be used for prognosis of germ cell tumor.

트리코모나스 질염에서 메트로나다졸 1.5gm 단일 요법의 치료 효과

고재환,이응수 인제대학교 1999 仁濟醫學 Vol.20 No.1S

본 연구는 트리코모나스(trichomonas) 질염 환자의 치료 중 단일 요법을 사용한 12예와 기존의 분획 요법을 사용한 45예를 대상으로 비교 분석하여, 치료의 효용성을 임상학적인 측면에서 알아 보았다. 두 군사이의 재발률 비교에서 통계적인 유의성이 없었으며(p=0.303), 단일 요법과 분획 요법간의 불충분한 치료율면에서는 분획 요법에서 적은 것으로 통계적 의의를 보였으나(p<0.05), 두 군간의 재발자가 너무 적었고 단일 요법 군에서 불충분 치료 판정을 받은 2예는 모두 성상대자로부터 재감염된 것이 확인되어 실질적인 의미는 없었다. 대상 환자를 결혼 여부로 나누어 비교하였을 때 기혼군에 비해 미혼군이 재발률에서 통계적으로도 의의있게 적었는데(p<0.05), 이는 재발의 원인이 치료 방법의 차이가 아니라 다른 성상대자로부터의 재감염 때문으로 분석된다. 투여 중 혹은 투여 후의 합병증은 두 군 모두에서 없었으며, 결론적으로 메트로니다졸의 1.5gm 단일 투여 요법은 임상적으로 사용하기에 효율적이고 적합한 치료 방법이 되리라고 사료된다. Objectives: The purpose of this article is to report the result of the single-dose treatment using Metronidazole 1.5mg, which has been done at the Seoul Paik Hospital. Methods: For this study, the 57 patients who were diagnosed as Trichomonas at the Seoul Paik Hospital from March, 1998 through November. 1998, have been examined. Wet smear was done to diagnose Trichomonas with clue cell, fungus and leukocyte count, and serum VDRL, serum-HIV test, and Pap smear was done as well. Each patient was given a single-dose of Metronidazole 1.5mg, which became a group. At the same time, the contrasting group were treated with twice to four times of Tinidazole 500mg for 3 to 10 days. These patients were reexamined with the wet smear test after a week and a month from this treatment. Results: 1.Among 12 cases treated with the single-dose out of 57 diagnosed as Trichomonas vaginalis, the 2 cases have relapsed in three month after the treatment. The recurrence of 45 cases treated with multi-dose was 16(35.6%), and these 16 cases were proved to be reinfected(p = 0.303). 2.In comparison of the insufficient treatment using the single-dose with that using the multi-dose, the multi-dose seemed to be smaller number of the insufficient treatment (p<0.05). However, the case of the relapse in two groups was too small, and 2 cases were proved to be reinfected from sexual partners. 3.Among 5 cases who have been diagnosed as bacterial vaginosis after the treatment, the 3 cases have relapsed, and there was no statistical significance compared to the group with out bacterial vaginalis(p = 0.312). These 3 cases were reinfected recurrences. 4.12 single women were not relapsed into the disease after the treatment, while 18(40.0%) cases out of 45 married women were relapsed(p<0.05). It is analyzed that the factor of relapse was not insufficient treatment but reinfection from the sexual relationship after the treatment. 5.There were no side effects either during the treatment or after the treatment in both groups. Conclusion: To conclude. the single-dose 1.5mg Metronidazole could be used safely and effectively for Trichomonas vaginalis, and it could also reduce the side effect although using the same medication frequently.

산부인과학에 관련된 국내의 인터넷

고재환 인제대학교 1998 仁濟醫學 Vol.19 No.2

오늘날 이룩한 과학 문명은 모든 분야에 이용되고 있고 의학에 있어서도 예외는 아니다. 컴퓨터의 보급으로 인해 복잡했던 의학적 통계를 더욱 빨리 계산할 수 있게 되었고, 세계 곳곳에서 연구하는 의학 관련 논문은 더욱 체계화된 기술적 도움으로 의학의 집약이 이루어지고 있다. 게다가 인터넷의 등장으로 인해 세계는 더욱 가까워지고 의학적 지식의 교환도 활발히 이루어 지고 있다. 하지만 의학 분야에서 국내의 인터넷 이용은 아직 미흡한 것이 사실이다. 이에 본 연구에서는 국내의 산부인과 영역에서 유용한 인터넷의 주소를 수집 분석하여 인터넷 응용 가능성을 추정하고자 하였다. 1996년 3월부터 1998년 7월까지 인터넷에 관계된 자료를 서적과 잡지에서 수집하고, 인터넷을 통해 얻은 정보와 주소를 토대로 1998년 8월부터 1998년 11월까지 찾았던 모든 주소를 접속하는 방법으로 국내에서 산부인과학에 관련된 정보를 분석하였다. 검색을 통해 얻은 모든 산부인과 관련 의료 주소는 368개였으며 이중 국내 주소가 65개였다. 303개의 국외 주소 중 접속이 않된 경우가 28개(9.2%)였고, 접속 시간이 30초 이상인 경우가 55개(20.0%)였다. 국내 주소에서는 접속 불량이 11개(16.9%)였으며, 국외에 비해 국내의 접속 속도는 접속 시간대에 따라 큰 차이를 보였다. 비용을 들이지 않고도 사용 가능한 검색 도구는 국내와 국외를 구분하지 않았고 모두 14개였다. 본 연구에서 수집한 국내 의과 대학의 인터넷 주소는 모두 31개였으며, 이중 5개 주소가 접속 불량이었고 대부분 홈페이지에서 산부인과로 연결이 가능하였다. 단순히 홍보만을 목적으로한 주소는 제외하고 산부인과에 관련된 정보를 얻을 수 있는 주소만을 수록하였다. 산부인과와 관련된 국내의 주요 학회와 지회는 모두 7개였다. Objective: The purpose of this article is to collect and analyze the Internet sites concerning the field of obstetrics and gynecology in Korea, and study the effectiveness of the internet toward the medical science. Methods: First of all, the information of the Internet relaxed to Obstetrics and Gynecology produced during the period of March, 1996 through July. 1998 was collected and examined from the several sources such as the books and the journals. Then, all possible sites about obstetrics and gynecology were connected and rearranged during August through November, 1998. In the course of this study, two kinds of computers haute been employed. One is the notebook computer which is Pentium MMX-166 MHz CPU, 48Megabyte RAM, and installed wish 56,600bps modem. The other one is the desktop computer wish Pentium II-300 MHz CPU, 64Megabyte RAM, and also 56,600bps modem. The Window 95 from Microsoft was used for both of computers as an operating system, and Internet Explorer 4.0 was used for Web browser. Also, Internet service provided by Uniwin were used, and the modem and the telephone cable were the main equipments for the connection. Results: The 368 medical sites in relation to obstetrics and gynecology including 65 of domestic sites have been found from the search. The 28 sites(9.2%) out of the 303 outside sites were not connected at all, and the 55 sites(20.0%) took more than 30 seconds to be connected. Among the 65 domestic sites, 11 (16.9%) were not connected, and the speed of the connection to the domestic sites seemed to depend on what time the connection is made during a day. There are 14 search engines available without any expense, and the 31 sites of the domestic medical schools, of which 5 sites are not connected. Moreover, the 7 domestic societies and organizations concernig obstetrics and gynecology can be found as well. Conclusion: As observed in this article, it is expected that this study can help many researchers to obtain more medical information easily. Since more and more researchers in this country are becoming interested in the Internet as well, the activated use of the Internet will have an important role on the future medical science.

트리코모나스 질염에서 메트로니다졸 1.5gm 단일 요법의 치료효과

고재환,이응수 인제대학교 1999 仁濟醫學 Vol.20 No.1